Module 2: Working with the Amygdala

Credit

Speaker

Catherine Pittman Ph.D., PhD, HSPP Related seminars and products

Saint Mary's College

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Target Audience

Objectives

1. Demonstrate to clients the neurological processes underlying anxiety in a clearly understandable manner that enhances client motivation.
2. Incorporate personalized goals to increase client engagement and focus client efforts on making lasting changes in the brain.
3. Characterize the differences between amygdala-based and cortex-based anxiety symptoms in order to select the most effective treatment interventions.
4. Individualize practical and evidence-based methods to resist anxiety and improve symptom management in clients.
5. Demonstrate strategies for calming the amygdala without use of medication to improve client level of functioning.
6. Recommend exposure-based strategies that change the amygdala responses to triggers to reduce anxiety symptoms.
7. Employ a variety of strategies to improve clinical outcomes utilizing evidence-based strategies that target cortex-based responding, including cognitive restructuring, psychoeducation, cognitive defusion, distraction, and mindfulness.
8. Differentiate symptom-producing cognitions characteristic of specific disorders, including Obsessive Compulsive Disorder, Generalized Anxiety Disorder, Social Anxiety Disorder, and Post-Traumatic Stress Disorder as it relates to case conceptualization.
9. Analyze the clinical implications of how SSRIs and SNRIs promote the process of treating anxiety.
10. Determine detrimental effects of benzodiazepines as it relates to anxiety treatment outcomes.
11. Differentiate between rebound anxiety and relapse symptoms to inform the clinician’s choice of treatment interventions.
12. Breakdown the key elements of mindfulness practices in managing symptoms of anxiety.
13. Present client education exercises that can be utilized in session to train clients in the use of mindfulness techniques.
14. Appraise common reactions to aversion and utilize clinical strategies to replace them with mindfulness.
15. Reframe exposure as an opportunity to teach the amygdala new responses in order to improve client engagement and treatment compliance.
16. Utilize clinical strategies for exposure that reduce avoidance and train clients to push through anxiety.
17. Employ effective strategies for reducing anxiety symptoms utilizing imaginal and in vivo exposure, including use of SUDS and attention to interceptive triggers.
18. Provide clinical strategies for managing comorbid depression that reduce worry, rumination, and common cognitive errors while promoting positive thinking and social interaction.
19. Use cognitive restructuring and cognitive strategies for managing symptoms of OCD and GAD that focus on scheduling obsession/worries and promote client acceptance of uncertainty.
20. Implement interventions in a clinical setting that use a reconsolidation approach to reactivate a symptom-producing memory and disconfirm it.

Outline

Module 2: Working with the Amygdala

• Explaining the Amygdala’s Role in Anxiety
  • The protective, evolutionary role of the amygdala
  • The amygdala and the stress/fear/anxiety response
  • The role of the amygdala in forming emotional memories
  • Explaining the Fight/Flight/Freeze response to clients
  • Teaching the amygdala
  • The language of the amygdala - communicating alarms and relying on pairings
  • Why the amygdala needs experience to learn
  • How “Triggers” are created in the amygdala

• Managing the Amygdala
  • Essential for all Anxiety Disorders, PTSD, OCD, Depression
  • Symptomatic behavior is often a response to amygdala activation          
  • Interventions that impact the amygdala
  • The Vagus nerve’s role in recovery from the activation of the sympathetic nervous system
  • Interventions that reduce activation in the amygdala over time
  • Communicating with your client to enhance treatment compliance
  • Exposure: activating the fear circuitry created in the amygdala to generate new connections
  • Tips for effective exposure strategies
  • Exposure with response prevention is essential when treating OCD
• Limitations and Risks in Neuroscience-Informed Treatment of Anxiety
  • The efficacy of evidence based treatments differ by individual and context
  • Research is constantly evolving
  • Using analogies and other psychoeducation communication
  • Medication information and interaction with interventions
  • More studies needed to support some observed clinical outcomes

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